The Archives of Bone and Joint Surgery

The Archives of Bone and Joint Surgery

Clinical and Radiological Results after Endoscopic Treatment for Gluteal Tendon Injuries with a Minimum Follow-Up of 12 Months

Document Type : RESEARCH PAPER

Authors
Alexandre Carneiro Bitar 1
Julio Brandão Guimarães 2
Ricardo Marques 1
Christiano Augusto de Castro Trindade 1
Alípio Gomes Ormond Filho 2
Marcelo Astolfi Caetano Nico 2
Henrique Antônio Berwanger de Amorim Cabrita 1
1 Departamento de Ortopedia, Instituto Vita, São Paulo, SP, Brazil
2 Departamento de Radiologia Musculoesquelética, Fleury Medicina e Saúde, São Paulo, SP, Brazil
10.22038/abjs.2023.70495.3304
Abstract
Objectives: The study aimed to evaluate the clinical and radiological results after endoscopic repair of 
gluteus medius muscle injuries and proposed an anatomical classification for the different injury 
classes.
Methods: A retrospective case series, including patients who had undergone endoscopic repair of the hip abductor 
tendon. The surgical procedure was standardized. Magnetic resonance imaging (MRI) studies were analyzed, and 
the injuries were classified into three types: nontransfixing partial-extension (nTPE) tear, transfixing partial-extension 
(TPE) tear, and transfixing full-extension (TFE) tear. TPE and TFE were considered high-grade tears. The 
postoperative outcomes were as follows: duration of walking aid requirement, duration of physical therapy, time to 
return to daily activities, modified Harris Hip score (mHHS) and Nonarthritic Hip Score (NAHS) functional scores, 
pain visual analog scale (VAS), satisfaction, claudication, Trendelenburg test, and reoperation.
Results: Sixteen patients were included (94% women; mean age 65 years), with a mean follow-up of 42 months 
(12-131, range). Out of the cases with preoperative exams available for analysis, four cases (31%) were nTPE, 
three (23%) TPE, and six (46%) TFE tears. Thus, 69% of the patients had high-grade injuries. These patients had 
a higher degree of fat infiltration (P = 0.034), but this was not correlated with inferior postoperative clinical or 
radiological results. One patient required reoperation due to a recurrent injury.
Conclusion: Isolated extra-articular injuries to the tendons of the gluteus medius and minimus evolved satisfactorily 
after endoscopic repair. Due to the small number of cases, it was not possible to observe differences in outcomes 
between high-and low-grade injuries.
 Level of evidence: IV
Keywords
Anatomical classification
Endocospic treatment
Tendon injuries
Subjects
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The Archives of Bone and Joint Surgery
Volume 11, Issue 10
October 2023
Pages 641-648

  • Receive Date 06 February 2023
  • Revise Date 30 September 2023
  • Accept Date 26 August 2023